1639595846 NPI number — OLATHE HEALTH PHYSICIANS, INC.

Table of content: (NPI 1639595846)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639595846 NPI number — OLATHE HEALTH PHYSICIANS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OLATHE HEALTH PHYSICIANS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639595846
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/03/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20333 W 151ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OLATHE
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66061-5350
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-791-4461
Provider Business Mailing Address Fax Number:
913-324-8656

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20375 W 151ST ST
Provider Second Line Business Practice Location Address:
SUITE 208
Provider Business Practice Location Address City Name:
OLATHE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66061-5306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-780-4000
Provider Business Practice Location Address Fax Number:
913-780-4038
Provider Enumeration Date:
03/12/2014

Additional Information

Authorized Official

Authorized Official Last Name:
WIENS
Authorized Official First Name:
CATHERINE
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
VP/QUALITY AND COMPLIANCE
Authorized Official Telephone Number:
913-791-4459

Provider Taxonomy Codes

  • Taxonomy code: 207RX0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085R0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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